踝关节生物力学.ppt

Anterior Drawer Test Talar Tilt Test 第三十页，共54页。 Kleiger’s test Used primarily to determine extent of damage to the deltoid ligament and may be used to evaluate distal ankle syndesmosis, anterior/posterior tibiofibular ligaments and the interosseus membrane With lower leg stabilized, foot is rotated laterally to stress the deltoid Medial Subtalar Glide Test Performed to determine presence of excessive medial translation of the calcaneus on the talus Talus is stabilized in subtalar neutral, while other hand glides the calcaneus, medially A positive test presents with excessive movement, indicating injury to the lateral ligaments 第三十一页，共54页。 Kleiger’s Test Medial Subtalar Glide Test 第三十二页，共54页。 Functional Tests While weight bearing the following should be performed Walk on toes (plantar flexion) Walk on heels (dorsiflexion) Walk on lateral borders of feet (inversion) Walk on medial borders of feet (eversion) Hops on injured ankle Passive, active and resistive movements should be manually applied to determine joint integrity and muscle function If any of these are painful they should be avoided 第三十三页，共54页。 Prevention of Injury to the Ankle Stretching of the Achilles tendon Strengthening of the surrounding muscles Proprioceptive training: balance exercises and agility Wearing proper footwear and or tape when appropriate 第三十四页，共54页。 Specific Injuries Ankle Injuries: Sprains Single most common injury in athletics caused by sudden inversion or eversion moments Inversion Sprains Most common and result in injury to the lateral ligaments Anterior talofibular ligament is injured with inversion, plantar flexion and internal rotation Occasionally the force is great enough for an avulsion fracture to occur w/ the lateral malleolus 第三十五页，共54页。 Severity of sprains is graded (1-3) With inversion sprains the foot is forcefully inverted or occurs when the foot comes into contact w/ uneven surfaces 第三十六页，共54页。 第三十七页，共54页。 Grade 1 Inversion Ankle Sprain Etiology Occur